Stanton Glantz – liar or innumerate? New evidence says: both!

I am working on a couple of things that will lead to some original research appearing here. In the meantime, I will contribute to some ongoing discussions.

As my readers will know, I have had a long-time hobby project of trying to figure out to what extent that anti-tobacco extremist Stanton Glantz, a professor at UCSF (I assume he teaches innumeracy), is just utterly clueless about what he claims expertise in, or whether he is intentionally lying. You can search the archives and see that I have come to lean toward “intentionally dishonest” quite often, but he still offers enough detail about some of his claims that suggest he just does not understand simple scientific points.

Readers of this blog will know there are many of each kind of liar. My casual empiricism suggests that most institutions identified as anti-THR liars intentionally lie while most single individuals who are identified simply do not know what they are talking about (in which case their intentional lie is to claim expertise that they do not have and to try to inappropriately influence others’ beliefs). On the other hand, when individual anti-THR liars are at respectable universities, the trend shifts to them apparently knowing that they are lying. Of course, the anti-smoking operation at UCSF resembles a respectable university only in the sense that it takes place indoors. Bottom line: No clues about Glantz from general principles.

To find further evidence, consider a story that has been covered in twoposts by Michael Siegel, about Glantz’s interpretation of a recent research paper. The paper reported on a study of smokers who called “quit lines”, and was a basic overview of who they were, with a bit of semi-useful follow-up data. Like any such study, it is not very informative about anything, but not useless, and the authors seemed to understand this. The paper emphasized e-cigarettes, and the study asked why those who tried them did so (mostly to try to quit, of course). One of the observations in it was that those callers who had tried e-cigarettes in the past were a bit less likely to quit during a period after calling the quit line than those who had not. (Surprise! People who tried a very effective method for quitting but still kept smoking were the type of people who would not then quit a short time later.)

To be clear, the authors did not suggest any causal claims about this. Several commentators criticized the study authors for doing biased anti-e-cigarette research and drawing inappropriate conclusions. But if you read the paper, they really did not (the introduction about e-cigarettes was rather naive, but that is just a throw-away). Moreover, when they blogged about it, they actively disputed the inappropriate interpretation (subtext: they smacked Glantz down rather thoroughly), rather than employing the “public health” tactic of embellishing headline-generating claims that were not even in the paper. All in all, very respectable and honest work by the original authors.

Glantz, in what appeared to be a demonstration of his lack of knowledge of even elementary-level epidemiology, interpreted the study as evidence that e-cigarettes do not help smokers quit. He seemed genuinely unaware of what the study actually showed, even though any second-semester student should have been able to figure it out. There are some very basic epidemiologic concepts (selection bias, immortal person-time, unhealthy survivor effect) that anyone with a basic understanding of the science would see make it impossible to draw the conclusions that he did.

Basically, any smoker who “survived” the use of e-cigarettes and remained a smoker (i.e., trying e-cigarettes did not take them out of the study population) is necessarily someone for whom e-cigarettes are not an easy path to quitting. The mere fact that they were able to be studied meant that they are not among those who e-cigarettes were a good way to quit. Obviously this shows that e-cigarettes do not work for everyone (no shock there) but tells us nothing about how often they do work. Moreover, the fact that they tried e-cigarettes and also called a quit line suggests that they are looking for a personally acceptable way out of smoking and not finding it. Studying such a population can be interesting for some purposes, but obviously not for purposes of drawing conclusions about smokers in general.

The study authors understood this and presented it (though, I would argue, not as clearly as they could have). Expert readers noticed it without needing that clarification. Glantz, however, seemed genuinely oblivious, so score a point for the “innumerate” theory.

However, the plot thickens. Because this is a rare case where someone spouting a very specific anti-THR lie is actively shot down by the very people he claims to be citing, any further repetition of the lie is a clear indication of intentional dishonesty. As Siegel noted, it had been clearly pointed out to Glantz by himself and the study authors (and this was such a one-person issue that there is no possible way he did not receive multiple copies of each of these), and yet he persisted in making the exact claims, in particular in a radio interview. Score a decisive point for the “intentional liar” theory.

So the answer seems to be both. That is, Glantz seemed to have genuinely made the elementary error in his initial analysis, and seemed to believe what he was saying. And yet after he was definitively corrected, he kept saying it. So: Innumerate about the field he works in and actively dishonest in his public statements. He certainly chose his career path wisely, finding one of the few jobs for which those are considered beneficial traits.

Most readers will already know this, but I should have noted it explicitly for those who might not: Glantz’s original claim, that e-cigarettes do not help smokers quit, is obviously false and contrary to enormous amounts of evidence. Thus, this is not a mere case of someone making a plausible claim and citing it to a bit of evidence he did not understand, which would perhaps be more forgivable and thus not be quite so deserving of the response it got.

I think Stan is definitely more of a liar than an idiot. He thinks of himself as a war leader – fighting a war against tobacco, where the end justifies the means. He’s admitted it himself:

“……that’s the question that I have applied to my research relating to tobacco: If this comes out the way I think, will it make a difference [toward achieving the goal]. And if the answer is yes, then we do it, and if the answer is I don’t know, then we don’t bother. Okay? And that’s the criteria.”

Written Transcript Of 3-Day Conference Called “Revolt Against Tobacco,” L.A., 1992

I was trying to figure out why someone like Stanton Glantz does what he does. To make sense of Stanton Glantz’s lying and duplicity it helps to turn to the psychology of moral conviction. As a moral crusader, Glantz exhibits the three main characteristics of moral conviction as outlined by psychologist Linda Skitka.

First, moral convictions have the feature of universalism, that what he believes is not a matter of personal opinion, that his conviction is simply right and he thinks everyone else should believe the same way he does. Glantz’s moral conviction is that using tobacco or nicotine is wrong, period. And because it’s wrong your only choice is to support abstinence as the only solution.

Second, is that the moral conviction is experienced as the reality of how the world actually works. That tobacco is evil is so obvious that if you disagree with him you are stupid, dishonest, or evil. Because using tobacco is so obviously evil, he has a strong motivation to stop you if you believe otherwise.

Third, moral convictions evoke strong emotions in defending the moral standard. Such strong emotions can blind a person to reason and often results in impulsive behavior. When Glantz’s convictions are challenged, he is not going to “agree to disagree.” A much stronger response than that is required.

From a basic psychology perspective, this explains why Glantz feels no compunction about grossly over interpreting data, cherry picking features of data that conform to his world view, and otherwise being dishonest in his discourse on the topic. In short, all of these features of moral conviction account for why Glantz is such a lousy scientist and so poor at explaining science. He isn’t looking for fact or truth, but confirmation of what he already knows to be true. That doesn’t excuse his behavior, just helps explain it. Unfortunately, he has plenty of company with the same moral convictions.

April 26, 2016 Today in the New York Times, Glantz belittles research done by the Royal College of Physicians urging smokers to switch to electronic cigarettes.

He was foolish enough to say “They are taking England into a series of policies that five years from now they will really regret.” Since when does science include the ability to predict the future?

The Royal College of Physicians was two years ahead of the US in issuing a report on the dangers of smoking (1962).

Glantz is a politician more than a scientist, in the same way that Ancel Keys was when he lied to us all in the 1950’s that fat in our diet was bad and that carbohydrates were good for us.( no scientific study to support that claim) That piece of “science” has killed millions of people since, but Keys had a hell of a career for himself – near godlike status, just like Glance.

As we near Dr. Glantz’ retirement, let’s all resolve to make scientists adhere to facts at all times.

Tobacco Harm Reduction (THR)

THR is the public health strategy of encouraging smokers to switch to low-risk alternatives like smokeless tobacco and e-cigarettes. It is the only proven method for reducing smoking below about a fifth of the population once it becomes established. (So why would anyone be anti-THR? See the "About" page.)

The continuing scourge of [smoking]-produced disease is unlikely to yield to today’s "evidence-based" interventions. (scare quotes added) Kenneth E Warner; see post if the implications are not obvious

If someone says the sky is green, you prove that it’s actually blue, and the next day he comes back once again insisting that the sky is green, and this happens repeatedly, you eventually have to acknowledge that mannerly debate about the color of the sky just isn’t enough; you have to go meta, and talk about the fact that this guy and his friends just aren’t in the business of honest discussion. Paul Krugman

He who is merciful to the cruel will become cruel to the merciful. Ancient Midrash